This is a rare recording featuring the renowned and legendary American psychoanalyst, artist, playwright and author Alan Roland (1930-2023) and Pulkit Sharma, an Indian clinical psychologist, psychoanalytic therapist, spiritual counselor and author based in Pondicherry, India. Alan Roland was a pioneer in cross-cultural psychoanalysis and called out the western bias inherent in decades of European and American psychoanalysis. He was known for his deeper understanding of the Indian and the Japanese psyche which he developed by living in these countries and working psychotherapeutically with the local population for extended periods.
This is a recording of a clinical case discussion held at VIMHANS Hospital, Delhi (2012) where Pulkit Sharma presented a case of an Indian male client who became silent during the psychotherapy sessions and Alan Roland shared his deep insights and clinical experience on this theme. The case elucidates unconscious personality patterns and conflicts unique to the Indian psyche.
Psychoanalytic therapy continues to be a unique space in contemporary times where silence is welcomed with curiosity and openness unlike other psychotherapies which regard silence as a non-productive expression.
#psychoanalysis #silence #psychotherapy #pulkitsharmaclinicalpsychologist #authorpulkit
This is a recording of a clinical case discussion held at VIMHANS Hospital, Delhi (2012) where Pulkit Sharma presented a case of an Indian male client who became silent during the psychotherapy sessions and Alan Roland shared his deep insights and clinical experience on this theme. The case elucidates unconscious personality patterns and conflicts unique to the Indian psyche.
Psychoanalytic therapy continues to be a unique space in contemporary times where silence is welcomed with curiosity and openness unlike other psychotherapies which regard silence as a non-productive expression.
#psychoanalysis #silence #psychotherapy #pulkitsharmaclinicalpsychologist #authorpulkit
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LifestyleTranscript
00:01I have been seeing this case for more than one year now and he comes to me twice a week
00:10for therapy and it is a face to face therapy.
00:15I will just give a bit of a background. This is a 20 year old male patient. He is of
00:23thin build and in fact my very first impression of him when I met him for the very first time
00:30when he came to me was that I found him to be very awkward.
00:34There was something about him that when I saw this person, when I interacted with him, I found him to
00:39be awkward. And I got this feeling that he is not really made for therapy and though this was not
00:50as such a very conscious feeling I would say, it was more of an unconscious feeling.
00:55Now when I thought about this and when I looked back, I also somewhere unwittingly tried to discourage him a
01:03little bit from going somewhere else, from not coming to me kind of thing.
01:09Because I had the sense that he would not be a very good candidate for this kind of work.
01:18About his childhood, he said that the childhood was spent in a very large joint family. I mean, there are
01:26these four people in the nuclear family, he, his sister and both the parents.
01:30He is the older child, the sister is younger to him but they were living in a very large joint
01:37family where his, you know, his uncles and everyone from the grandfather's side were there.
01:46And then for the last few years they have been living as a nuclear family owing to some family conflicts
01:53between the brothers.
01:55And although he says that there are these conflicts also but still like the family has, you know, bonding and
02:04they interact a lot with each other.
02:07He reported that he is not attached to his parents or to his sister or any family members or anyone
02:15in fact, you know.
02:16He said that he has people whom he calls friends, he has a social circle, he has everyone but he
02:23is not attached to anyone kind of thing.
02:27And he also reported that every relationship had been extremely painful for him.
02:32Because he said that he gets this feeling that in any relationship there comes a point when he has to
02:40simply, you know, disregard his self or crush down his self to be in that relationship which he does not
02:48like.
02:49And then he eventually withdraws from the relationship.
02:53He does not terminate the relationship but he will just cut down his involvement and withdraw from the relationship.
03:00And he reported feeling very empty from inside and he felt that, you know, that there was no joy, no
03:07excitement and there was never any such, you know, feeling that he has experienced in long time.
03:15He, like to illustrate this, he mentioned that, you know, that I do give birthday treats and I do celebrate
03:21New Year and I do celebrate festivals but that's what I do because it has to be done.
03:27You know, I don't feel, you know, that it's something joyful or I feel happy doing it.
03:33It's just like that, you know, it's social obligations and compulsion, people are expecting that this has to be done
03:39so this is kind of done.
03:43And he also said that he actually sees no point in doing it and in fact he feels a very
03:49strong hatred for himself when he does such things.
03:53And a part of him always criticizes him and rebukes him in these moments for being very, very fake.
04:01He says that a voice tells me that, you know, you are not really enjoying it, you are not really
04:06into it, you really don't want to do it, so why the hell are you doing it?
04:09But still I can't do it.
04:12About his education, he is doing a B.Tech which is an engineering degree from a private college and is
04:19performing poorly at studies simply because he says that he does not study.
04:22You know, the same attitude is towards the study as well. He says that I don't want to kind of,
04:28you know, really do it, you know, but I am into it, so I have to sort of do it.
04:32He shared this fantasy that he actually wanted to be an actor but his family discouraged it and when he
04:38shared, you know, this with me, I also had a very similar attitude because, you know, I just, I just
04:43felt that he was like, you know, so much withdrawn and so much, you know, how could he just kind
04:48of, you know, I mean, how could he just want to be an actor?
04:51And that was my sense also. And about his childhood, he says that he was very good at studies initially,
05:00he was a very brilliant boy and about very early childhood, he also recalls that he was very playful, you
05:08know, that he used to kind of, you know, laugh, have fun, play.
05:13And throughout the last one year, you know, when he has been in therapy, he has predominantly talked about several
05:20instances where both his parents tried to rebuke him by saying that he is not good enough, you know.
05:27I mean, that has been a very strong experience. Further, he also recalled moments that whenever he was being free
05:35and playful, you know, like he said that once they were at a railway station, so he was just, you
05:40know, laughing and enjoying, you know, kind of thing because he saw something and the father came and he just
05:45gave him a tight slap and he said that what's there to laugh about kind of thing.
05:49And there have been like several instances where he got scolded very badly, you know, or where he got actually
05:58beaten up.
05:59He harbors intense rage towards his family and there is also a very intense guilt due to this rage, you
06:06know, so he would get negative emotions, then he would also really, you know, he would tell himself that you
06:13are really bad to think like this, you know, and I mean that you are the one who are bad.
06:20And from his interactions, it also came across to me that his parents, they seem to carry a very strong
06:26notion of how a child should be, you know, or of how they wanted their son to be.
06:31And whenever this person seems to deviate from that image, you know, they, to my mind it comes that they
06:39just could not probably tolerate it, you know, they found it hard to tolerate that.
06:42He also shared this instance that he was often compared with other children, you know, like whenever he did well
06:51in studies or whenever he scored well, he would come back.
06:53So his mother would often say that fine, you know, you have got good marks, but see this person, he
07:00is also a good student and into sports.
07:03And interestingly, these children were usually at least eight years or more older than him.
07:09You know, he was being compared not with, you know, people his age with people older than him, people who
07:15were eight years older, ten years older or even more kind of thing, you know.
07:20And about a lot of this, he also says that till a certain phase, I was just into this and
07:25I was living this.
07:26I really did not know what was this.
07:29And it's only now that I have started thinking about this, you know, that's what he says.
07:38As far as our sessions are concerned, he's very regular in the sessions, extremely regularly.
07:44He always is five to seven minutes before time.
07:48He's also very reflective and open in some sense, you know, that he would really think about, you know, what's
07:57happening.
07:57He's also very frank in sharing his feelings, you know, kind of thing.
08:04But despite this, in the initial ten months or so, I kind of, you know, found our interactions to be
08:10very formal, you know.
08:10That was my feeling that there was something very formal about the way our interactions were, you know.
08:16And interestingly, though I tend to be slightly informal while doing therapy with him, I also kind of, that was
08:24my experience that I was also, you know, saying and doing things quite formally somewhere, kind of thing.
08:29And what I mean by formal is that, you know, that image that will often come to my mind is
08:37that as if someone is reading a piece of news to me.
08:40Like, as you would see, you know, if you see like those old fashioned news readers who would be just,
08:49you know, saying everything in a monologue, you know, without any modulation, expression, emotion.
08:54So that's how he talks about himself and his entire history.
08:58He'd be talking about extremely traumatic emotions, rage, everything, but it would be in this kind of a news reader
09:05manner, yeah.
09:09And I had the sense that there was, you know, no emotional feel to whatever he said at times.
09:16He came to me after doing quite a careful research because he had been to two psychologists earlier and he
09:24terminated the treatment with the first one after three sessions and the second one after two months, you know.
09:32And what he simply said was that he had a feeling that he could not express himself over there, so
09:38he just kind of stopped the treatment.
09:43And once again when he told me this, I was actually, you know, I had the sense, oh, he's going
09:47to be here with me for also a month or two months and, you know, maybe like that, you know,
09:51kind of thing.
09:53That's what came to my mind.
09:56And he approached me because he actually kind of, you know, found out that I was, you know, I had
10:02a training in Psychonautic Therapy and I have also worked with traumatized people.
10:06So he came to me with this kind of a mindset, you know, that maybe with these experiences I would
10:14be able to help him.
10:16About his strength, he is very well read in philosophy and psychology and, you know, so he knows at times
10:25what he's talking about.
10:26And he came with an expectation, that was the image of therapy that he, you know, brought in.
10:31He said that it's as if that, you know, that myself is like a book.
10:35And there are certain very bad, unwanted, ugly pages in the book and I am hopeful that he would just
10:42help me tear out those pages and remove them.
10:45You know, that was the metaphor of therapy that he brought.
10:51And in a session, as I said, they were like very formal.
10:56But whenever there would be such moments, you know, when the formal structure went slightly missing, then he would feel
11:04extremely awkward, you know.
11:06And what I mean by that is that if the session is like this, that he knocks at my door
11:11at the set time and comes in, he talks and he goes away.
11:14So it's fine.
11:15But if, say, he is early and I simply walk out of my room into the waiting area or I
11:21am going somewhere.
11:22And if we kind of, you know, meet somewhere on the way, he would get very uneasy.
11:26You know, he would get very uneasy and in the initial stages he will just see me and he will
11:31actually almost run away in the opposite direction kind of thing, you know.
11:40And then he would come back, you know, and he would also at times say that, you know, that when
11:45I see you like this, I feel extremely awkward that, you know, that what should I be doing in that
11:49situation.
11:50And so I do this, you know.
11:52And interestingly, somewhere, you know, for in the initial months, I also saw this paranormal kind of a thing in
12:01me at times that I would be slightly forgetful, you know, about him.
12:07Like, I am supposed to give him a monthly bill, you know, of the sessions that he has because it's
12:14for some insurance purpose and I would kind of, you know, like I would forget to make that bill, which
12:22is really not the case with, you know, the way I normally am kind of thing, you know.
12:27And I think in the initial two months, I actually, you know, I told him twice that, oh, I have
12:37forgotten today, I will get it the next time.
12:40And the next time also this happened and the third time also this happened until I kind of, you know,
12:43had a feeling that what is really happening, you know, kind of thing.
12:47Yeah, and so I did get this feeling that, you know, from my initial impression of him and this, there
12:56are these two, you know, sense that I have.
12:59On one hand, somewhere I find him actually very gifted in some ways, very reflective in some ways, I look
13:05forward to working with him.
13:06But there is also this undercurrent where I think I sort of, there is a part of me, you know,
13:14which kind of is, probably wants to, you know, be distant from him, away from him, you know, kind of
13:23thing, not keep him in my mind, things like that.
13:26And, you know, when this kind of came to my mind and I then became, you know, much more attentive
13:31that I, you know, stopped, you know, I tried my best that I don't, you know, repeat these things kind
13:38of, you know, things.
13:39So that was there.
13:42And now I will just come to a very recent phase of, you know, therapy.
13:49So, which is like, after, like, you know, this, I mean, you know, so, this was the work that was
13:56happening for the, you know, for the initial 10 to 11 months, that he would just come, he would be
14:00simply talking about his past, there would be a narrative, he would recall a few things, and then he would
14:07just go back.
14:07He would really talk about his present, and what was happening now, and what he was doing, he would not
14:13talk about his course, his college, his exams, or whatever, but he would just talk about this and leave, yeah.
14:20And then came a phase when, you know, he became totally silent, you know, in one particular session, he became
14:27totally silent, then he came to the next session, he was silent, and then when he came subsequently, he told
14:32me that, look, you know, I have really run out of the material,
14:36because I've told, I think I've told you everything from, you know, my, this, you know, past, you know, that's
14:43complete, I've run out of material, and I have nothing else to say, so he requested, he said that, look,
14:49you are a psychologist, I know, and, you know, there are many interesting tests in psychology, so I, there's nothing
14:56else coming to my mind, so why don't you give me thematic perception test, or Rorschach, so that I could,
15:00you know, fill in my time.
15:03So, I kind of, you know, I smiled and explained to him, I said that, obviously, that is a good
15:10way to occupy time, I mean, if I start giving you tests, and I have, you know, quite a lot
15:14of them, to fill in that time, but I said, that, you know, I mean, obviously, my sense was that
15:20there's something happening, you know, kind of thing, and I should not, kind of, you know, let it go away.
15:26So, I said that, I mean, that surely is an option, but if it's not too difficult for him, so
15:32let's try and see that what is happening, and, you know, that, what is this silence about, how is he
15:39feeling, and where are we now, and, you know, so I told him, let's just stay with, you know, what's
15:45happening, and hopefully see what comes up.
15:51In the next session, then, he shared that he felt scared that if he continued to be silent, I would
15:57tell him that he was wasting my time, and I would throw him out of therapy, so that he, you
16:03know, so he said that, that's why I feel that I should do something constructive over here, kind of thing.
16:09And so, I obviously, kind of, you know, discuss this thing with him more, you know, that, why did he
16:14feel, you know, that I would throw him out of therapy.
16:17Now, another interesting thing, I am quite confused about this aspect, that whether this is a strength or what it
16:23is, whenever I, kind of, discuss something transparent with him, you know, that whenever I would say something like this,
16:29that, fine, you have this impression, so what makes you feel like this, you know, or what about me gives
16:34you the sense, you know, that I may throw you out, or, you know,
16:38something like that, he very quickly says that, no, no, no, look, you know, it's not about you, you know,
16:43it's not about you, I know that this is going to happen with any person, you know, or it can
16:48happen with any friend, or any other psychologist who might say, it's not about you, kind of thing, you know,
16:52so that's what he says, which on one hand makes me feel that he understands, he's quite respectable, on the
16:59other hand, it also, you know, makes me feel that he is not comfortable,
17:07probably experiencing these feelings in relation to me, and expressing them, you know, in a very, you know, in a
17:14very open manner, kind of thing, but I haven't shared this thing with him, any days, so what happened is
17:21that when we discussed this fear, he felt slightly at ease, and he said that he would, you know, try
17:27and look at whatever was happening,
17:30and so he agreed, and then what happened is that they actually came in a phase that for the next
17:35few, quite a few sessions, it was a significant time, he was absolutely silent, he would come for the session,
17:42he would sit across,
17:44the entire session would be, like, no, both of us will be silent, he'll get up after, you know, when
17:49the session ends, go out, you know, the next session, he'll come on time, and, you know, this, like,
17:55it was a very much testing time for me, kind of thing, because I, somewhere, actually, was also anxious, like,
18:03what was happening, you know, and I wanted to, you know, kind of ask him that, how are you feeling,
18:08what's happening, and, you know, where are you going,
18:11what's happening, but my sense was also this, that, you know, that I also had this in mind, that it
18:17already, kind of, you know, given me the sense, that it should not be that I am expecting him to
18:22speak, or expecting him to be, in a certain way, in my work with him, because I had a sense,
18:27that if I, given that sense, then, you know, then,
18:30his fear would be, sort of, you know, kind of, you know, confirmed, or reinforced, that I also want him
18:36to, maybe, speak, or maybe, you know, do psychological tests, or give me some interesting data, and I can't, you
18:42know, really be with assignments, so, I kind of, you know, I tried my best to be, kind of, you
18:47know, silent, you know, in those sessions, I would also not really say anything, you know, only once, after, you
18:54know, then,
18:55and, and my general feeling in these sessions would be that, one, I would be, you know, have this confusion,
19:04secondly, I started feeling extremely sleepy, you know, in these sessions, interestingly, you know, that was not a boring sleep,
19:15you know, so, that's the interesting part, this was a very blissful sleep, you know, there's something very nice about
19:21this, you know, sleep, and, I mean,
19:24I would, it would be so heavy, that I would have to, you know, at times, I'd have to move
19:29myself, I'd have to drink water to keep myself up, you know, because, and I, and I so dearly wanted
19:34that, you know, I should have put him on a couch, you know, so that even if I slept, he
19:39could have been fine, but then we were, like, you know, face to face, but, you know, when I was
19:45sleeping, so, you know, the, you know, the fantasy, or the feeling, or the memory that would come to my
19:51mind was, you know, that, as if, like, you know,
19:54I mean, I would recall this time, when I was a baby, you know, or a very small child, and
20:00then someone would really hold me, you know, and I would be, kind of, you know, sleeping in that person's
20:04lap, you know, so, that was, and this whole sense that, as if you are, you know, slipping into some
20:10kind of a fusion, which is a very deep sleep, that you are helped by someone, and there was something
20:17very peaceful, deep, and wistful about this, you know, so, then, after a few sessions, I mean, when the,
20:24the silence was continuing, like this, so, I thought that I just asked him once, so, I said that, I
20:29said, look, I'm fine with the, whatever you wish to do in the session, it's your session, you know, whether
20:35you stay silent, or you talk, or you do something else, you know, I'm happy to give you that space,
20:40but, I said, I'm really curious that, what does this silence mean, and how you feel about it, and whether
20:47it is helping you in some ways, or it is not helping you in some ways, or, like, you know,
20:51what's happening,
20:52So, at this moment, he smiled, and he said, that though he initially felt extremely scared to be silent, you
20:59know, and he always thought that I expected him to do something, now, he had developed comfort with it, and,
21:05in fact, he enjoyed silence, you know, and, he told me that he slips into fantasies, you know, he plays
21:12with his fingers, and he actually finds this silence very peaceful, and very good, you know, he said that there
21:17is something healing about this silence.
21:19So, I did, at that time, recall in my mind, that I also go through similar experience, you know, in
21:23his presence, when I, you know, when I almost start slipping into that sleep, and, then, in one particular session,
21:33this, again, happened, that after keeping silent for a long time, he, all of a sudden, asked me about a
21:39room freshener, which is lying there in my room,
21:43that was after a long period, you know, of, he asked about this, a part of me, thought of responding
21:50in the usual way, as you would do in a psychodynamic therapy, that you would, you know, kind of ask
21:54that, fine, you know, so, what comes to your mind with the room freshener, or what, what does it mean
21:59to you, what does it signify, tell me more about it, what do you have in mind?
22:04Here, I don't know, I somehow felt shaky to take this up, because I was like that he has been
22:08silent for so long, and now this is the contact that he is making with me, that he is asking
22:13me something, so, I did not, I at least felt at that point of time, that he is wanting to
22:19connect to me, and maybe if I kind of, you know, respond in a very standard way, that may come
22:23across as cold to him, you know, that I was pushing him away.
22:27So, what I simply said here, was that, I kind of, you know, I also smiled back, and I said
22:35that it's a room freshener, and he smiled back, you know, then he was silent again, but then after a
22:41while he said that he wanted to ask me a few more things, but felt scared that it will be
22:47unprofessional, and it will be not permitted.
22:50He said that, I may get angry, and when I asked him, what gave him that sense, that I may
22:55get angry, he once again said that, look, it's nothing about you, that's in the sense that I have in
23:00all relationships, and, you know, that's what I would have, that has got nothing really to do with you.
23:09So, here, at this moment, then I did share this feeling, you know, with him, and I said that, you
23:15know, that I have a feeling that, now, actually, interaction has been, like, you know, quite formal at times, and
23:20maybe a part of you wishes to be spontaneous over here with me, but you feel very scared of my
23:26reaction, you feel that I would not really, kind of, you know, welcome it, or I would be very, you
23:32know, I would not really like you to be spontaneous.
23:35He agreed to it, and then he said that he wanted to be, kind of, you know, free, you know,
23:42and then after a while, he shared several instances from his childhood and teenage, where people forced him to leave
23:50his perspective and take up their, he says that in all the relationship that happens, you know, that whenever he's
23:57interacting with someone, after a while, he feels compelled to take up that person's perspective brutally,
24:04and leave his, you know, and then after a while, you know, and then after a while, then he feels
24:07complete loss of his perspective.
24:10So, in the session also, he expressed a fear of being controlled, he said that, you know, I have the
24:15sense that, you know, if I get close to someone, someone may tamper with my mind.
24:20I once again said that it could be another reason that why, despite, you know, really wishing to be spontaneous,
24:26he was unable to do so.
24:28He agreed to this, and he said that, yeah, it could be like that, and then I kind of also
24:38asked him, I said that, you know, that for almost a year, we have been discussing very traumatic incidents about
24:43your life,
24:45but when you talk, you know, I have times really notice, you know, that, where are your feelings, you know,
24:51kind of thing, and he thought for a while, and he mentioned, he said that, look, there are a lot
24:55of feelings inside me, I feel very enraged, I feel very hurt, but I usually keep them to myself.
25:03He said that, this was because he felt expressing pain was being weak, and he hated it, and he said
25:10that also, if he expressed it, he could get very abusive and out of control, you know, if he started
25:16expressing those emotions, and so he was keeping it all inside very tightly, you know, so here I said, I
25:22said that we need to, you know, find ways to reach these emotions, but I think that when he said
25:27that he could be very abusive and assaulted, I was somewhere scared of his, you know,
25:31a rage and whatever was inside him, kind of thing, you know, because I had that sense. In the next
25:38few sessions, we talked more about his fear that, you know, that he could be aggressive towards me, and, you
25:48know, so we then, you know, discussed several themes around it, so one was that, that this was the pattern
25:58of relating he had seen in his life, you know, he felt,
26:01so put down by everyone, that the only way he could think of an interaction, or the only way he
26:07could think of holding himself together, was by, you know, putting this awful experience into someone else.
26:14Secondly, he also felt scared that if he tries to get close to me, I'll be put off by it,
26:20just as his parents were, and that he would, you know, once again get re-traumatized.
26:27By discussing these fears, he seemed to feel slightly more comfortable, and became somewhat more open, in like, you know,
26:34the next session, which was the second last session, then I'll just come to the last session.
26:40So in the second last session that we had, he just came, he was actually very spontaneous that day, he
26:45came and he smiled, he gave me a very big smile, and he complimented me on my dressing sense, and
26:53he said, he said that I have a lot of passion in whatever I do, you know, he was saying
27:01that I feel that you have a lot of passion in whatever you do, you are a psychologist, because it
27:06seems that you always wanted to be a psychologist,
27:08it was not that you accidentally came to this, and that you are in a lot of control of yourself,
27:15and you know, you do things because you enjoy them, it's not that, you know, because you have to do
27:19them kind of thing.
27:22He also said that all this was in a very stark contrast to people he had seen in his life.
27:29And he also then reflected back, he himself said, he said, initially when I came to you, I felt extremely
27:36scared, you know, whenever you would understand me, because I used to think that no one can really understand me,
27:45but over the last one year, he said that I find you different from everyone, and I almost started relating
27:55to you.
27:56He shared an inner image where he saw himself standing in a round hall full of doors. He said that
28:02all the doors are the same, but he was beginning to see that one particular door which represented me was
28:08different.
28:09He said he was feeling a sense of trust and positivity. In relation to this, I had several thoughts and
28:16emotions with what he said.
28:17Firstly, I kind of, you know, felt slightly amazed by kind of, you know, his, you could say, his intuitiveness,
28:24because what he had shared about me, I mean, a large part of it was very true, without, you know,
28:29me having, you know, mentioned to, ever to him, you know, that why I was a psychologist or what I
28:35like doing or not doing, but that was somewhere quite true.
28:39And the whole experience was that as if, you know, he could somewhere see through me and almost, you know,
28:45you know, that he had seen very well through me.
28:48Secondly, I felt happy that he had found some hope in our work, you know, because I also recall that
28:53when I long back discussed this case with someone after initial sessions,
28:57so that person really told me that it was a pretty hopeless case because this person had no good attachment
29:03in his life, you know, there was no one in his life as such.
29:07And thirdly, I also experienced being put on a high pedestal, which no wonder felt good, but it also felt
29:13scary, you know, it felt quite scary to be somewhere, you know, admired, to be held, kind of thing, there
29:21was something scary about that.
29:24So that was where the session ended, and then this last session, so after the, you know, this session, he,
29:32when he came in, in our last session, which we have till date,
29:37he seemed to go back to, like, you know, the old self, he came in and he was, you know,
29:41quite silent, you know, and when he started the session very reluctantly by saying that the guard near my room
29:50was trying to be friendly with him,
29:51and he felt very awkward and very scared, you know, by the guard, though he again said that, you know,
29:56that that's okay if the guard wants to be friendly with me, I understand that's not a problem with me,
30:02you know, that that's a problem with me, but not with the guard, you know, kind of thing. And then
30:08he went on and said that he prefers loneliness and being with people was just too much.
30:15So here, you know, because there was such a stark contrast between the two sessions, so I just asked him,
30:20I, you know, got into his attention on last session,
30:24and I asked him that, look, you know, that I wonder whether this has something to do with, you know,
30:29what happened in the last session, you know, that you felt extremely close to me,
30:33and today you are again talking about, you know, that how closeness is very scary and how you would be
30:38rather alone, you know, kind of thing.
30:41So, he thought about that and he said that indeed he felt very scared after the last session we had.
30:48He said he had a feeling if he had given me too much of a par by admitting that I
30:53was important for him,
30:54and now I might coerce my views on him, you know, kind of thing. And he once again quickly added,
31:01when I tried going further into it, that this had nothing to do with me,
31:05but this is the general sense he would have with everyone. So, that's actually very interesting, you know, that you
31:11touch upon the transcendent,
31:13but you can't really go, you know, a lot with it because then you get to know the people, no,
31:18no, no, it's not about you kind of thing.
31:19And, yeah, and then he also said that in any new place in relationship he feels comfortable in the beginning,
31:29but then withdraws into himself because when his perspective differs from people, he cannot hold his ground.
31:36And, you know, their perspective becomes his perspective. He also said that he was feeling overwhelmed in the last session
31:42when he was talking about me, which he now felt to be very stupid and sentimental, you know.
31:48And he also shared that, you know, whenever he has been emotional in his life, he got this message, you
31:53know,
31:53that people around him with jewelry say that you are being an emotional fool, you know.
31:57And, so, you know, that he does not feel very comfortable about it. So, stop there. Yeah.
32:07Can you make the last one?
32:13Well, this is a very interesting case. I think very sensitively presented and with some wonderful questions from all of
32:25you.
32:26First, before I get into the case, let me answer this one question that was put aside, an important question,
32:34but not necessarily relevant to the case.
32:37Okay, get that out of the way. Why, if you become a psychoanalyst, you have to go through your own
32:46personal analysis?
32:47I think the reason behind it is it's assumed that none of us are completely free from unconscious conflicts and
33:03issues.
33:04And the more we can become in touch with them and resolve them, the better we are with patients, that
33:16you understand more what goes on inside of patients.
33:21That's, I think, the basic reason. It used to be, I know in some institutes, that the analyst who would
33:36conduct the analysis with someone in training would have to report to the institute how their analyst was doing.
33:47We felt at our institute, and now it's the same in others too, that this was a very bad idea.
33:56It's not a case of being evaluated in your analysis. That's one thing that will prevent an analysis from being
34:05at all effective.
34:07So, it should be kept confidential, and the person in and out should have no fear whatsoever of being evaluated.
34:18And anyway, let me get to the case now. This is, I said, a very interesting case. Let me tell
34:25you my, I think Dr. Sharma described very well what he did, and I think a lot of it was
34:32very effective.
34:32Let me tell you a little bit of my understanding of what went on.
34:40The patient comes and for a long time presents himself, Dr. Sharma says, in a rather formal way during the
34:51procedures,
34:51tell him all about his past, nothing about anything in the future, or in the present, I should say, what's
35:00going on.
35:02In other words, as if he's being very dutiful, doing what's expected in psychoanalytic therapy.
35:16Then, all of a sudden, one session, he announces, I've run out of material. I've told you everything.
35:22You know, in effect, why should we even continue?
35:27Now, often this comes up in a somewhat different way, in my experience.
35:34And that is, the patient talks about problems they're having.
35:40They're having this problem, they're having that problem, they're having another problem you work on,
35:45problem, problem, problem.
35:46All of a sudden, one day, they come in and say, you know, I'm feeling a lot better.
35:53I don't have any problems to discuss. Why should we continue?
35:58Now, what I find with that is it's a very subtle transference that's going on.
36:08And the way I understand it, it's telling you that the relationship I've had with my parents is a very
36:19conditional one.
36:21That only if I'm a certain way will I be loved.
36:27So that in therapy, only if I tell you all about my past will I be an accepted patient by
36:36you.
36:37Or only if I tell you my problems will you accept me as a patient.
36:47And from what Dr. Sharma described, it tallies very much with the parents, not only high expectation,
36:56but you have to live up to these expectations, otherwise we don't love you, we rebuke you, etc.
37:02That becomes now lived out with the therapist in this form of I've told you everything, I have nothing more
37:11to discuss.
37:13Then the patient becomes silent.
37:18And if I understand it right, Dr. Sharma begins experiencing at first his own uneasiness, as any of us would.
37:28But it's not only that, I think his uneasiness also reflects the patient's own feeling of anxiety, of will this
37:40be tolerated?
37:41If I'm not doing what's expected of me in therapy, will you tolerate me or throw me out?
37:51With the fear of being thrown out.
37:56And I think Dr. Sharma very well tolerated it, realized it was important.
38:04And then comes this very interesting thing.
38:10A therapist sometimes, you can go into a session, you've seen other patients, you feel very alive,
38:17and all of a sudden with a patient, you start feeling like you could go to sleep at any minute.
38:23It's a very interesting kind of thing.
38:27Not under your control whatsoever.
38:32Usually, in my experience, most of the time that happens, it's when a patient starts dissociating feelings that are coming
38:45up in the therapy with the therapist.
38:56And what one finds, you know, when we interact with each other, I think there's a certain energy that goes
39:06back and forth that keeps one alive.
39:11You give out the energy of the other person to you.
39:14If you're with someone who's dissociating the feelings that the feelings are entirely cut off, it will send you to
39:22sleep.
39:23So I think some of that was going along.
39:26But then Dr. Sharma has the interesting experience of his sleepiness becomes actually something, I don't know if one would
39:39quite say enjoyable, but pleasant.
39:43Very pleasant.
39:44Very pleasant, yes.
39:44Very pleasant.
39:45Very pleasant.
39:45Of being in the, sort of I think, lulled in the arms of a very small child, instant whatever, the
39:56arms of one parental figure or another, being comforted and held and all.
40:04And I'm wondering, there's a speculation, of course, if he wasn't then experiencing something of the patient's own regression in
40:19this silence that, after all, he said, this patient is not someone totally disabled.
40:29He has some wish, some strong wish to work out these problems that he has, and I wonder if there
40:40wasn't in his early childhood, as he even said, he would be joyful and whatever, this very comforting presence.
40:49It's only as he gets someone older in childhood that this very conditional acceptance of him gets expressed, that he
41:02must be a certain way.
41:04And in fact, I think that's what makes it so difficult in relationships that he feels if he's close to
41:11someone who loses himself, he has to take the other person's perspective.
41:18As well as what Dr. Sharma talked about, anger could come up, too, of there being this conditional acceptance.
41:30And in fact, I think the rage has to be, to a great extent, either contained, repressed, or dissociated, because
41:44if the relationship is very conditional, anger at the other will lose the relationship.
41:53That's the feeling.
41:55That's the feeling.
41:55So I think there's a, the testing of Dr. Sharma, which continues with the asking questions of him, but let
42:06me just say another comment about silence.
42:10In psychoanalysis silence, silence had been really considered as a resistance, that you were holding back something, often feelings about
42:25the therapist.
42:28But there was a very interesting paper written in America, no less by an Indian Bengali woman in psychoanalysis herself
42:40and in training to be an analyst, who happens to be married to Salman Akhtar now.
42:49Oh, Dr. Monisha.
42:51Monisha, yeah.
42:52And what she did, and she finally convinced her own analyst, and she cited some poems by Rabindranath Tagore, that
43:05silence can also be a way of being more in touch with yourself, not necessarily as a resistance.
43:14And, um, she had to convince her therapist of this, but she wrote a paper that went against the prevailing
43:23psychoanalytic notions of silence.
43:26But I think this, um, continued in, uh, asking questions of Dr. Sharma, feeling again, anticipating his anger, um, that
43:42the patient will be thrown out of therapy.
43:45So there's a testing of him, I would say, as how conditional is this relationship.
43:53And I think that there's at times some, if you wish, regression to withdrawing and all.
44:01Well, it's not that the therapy hasn't been successful, but there needs further work.
44:07Uh, because his, um, being, um, I think with the, not only the fear of being thrown out, but the
44:22fear of his own anger thrown out of control.
44:25But I think, uh, at least as I see it, there was considerable, extremely important movement, and, uh, very nice
44:37handling of the transference relationship as it went on with Dr. Sharma.
44:47Okay, that's my comment on it.
44:55Anyone would like to put any question to Dr. Roland, or otherwise we would just, uh, regarding morning or this
45:05case or whatever, yeah.
45:07So personally, a person has many relationships in his childhood, as well as her childhood.
45:12So how do you figure out that to, whether I am distrapping with the mother or father or the grandfather
45:19or grandmother or the child?
45:34That's a very good question, especially if this patient comes from a joint family.
45:39There can be any number of people.
45:45And not only that, but often you have to see, say if it is with a given parental figure, what
45:58aspect of the mother or the father is there a problem?
46:03Because we're not all made of one piece, and the parents are not all made of one piece either.
46:14So that different things can come out with different aspects of them.
46:19How would you know? I would say with this, and I think it was rather intense in this case, a
46:34very conditional relationship.
46:39If the mother had had a real, on the whole, more acceptance, loving acceptance of the patient, and it was
46:53the father who was like this, I don't think it would be so extreme.
47:00So I think a lot came from the mother or the mother in person, but I think it also, it
47:09sounds like it was joined in by the father and maybe by others too.
47:15Because there was also, I think, the fear of probably in the joint family of how this son would reflect
47:26on the family.
47:28And in fact, in his doing, what, fairly poorly in school, I found in work with some Indian patients that
47:39if they were told or forced to do something, they could not disagree with it and not do it.
47:50They had to go along, but it was done poorly.
47:57In fact, I know someone who became a major psychiatrist at Nimhan's from a shepherd background.
48:08And his father was a shepherd, but very interested in a committed Gandhian.
48:17This man was the first man from his community to go to college.
48:22He wanted to go to an engineering college.
48:25The father wanted him to go to medical school so he could help others.
48:31So he had to go to medical school.
48:34He said, I did so poorly in medical school that the only job I could get was in the army.
48:44And there I became interested in others' emotional problems.
48:49So I went on into psychiatry, then went over to England, was trained at Tavistock, and came back.
48:59And that's just one example of this.
49:02And I think there's some aspect in this case of, I can't express my rage directly, but by doing poorly,
49:13this won't enhance family reputation.
49:17This one gets back at you too.
49:25Anyone else?
49:30In reference to this case, because his family had to leave the rest of the joint family because of some
49:38issues between his uncles, could that also add to the feeling of conditionality to relationships?
49:45You know, they were a family once, but now they can't live together because somebody did something.
49:52Yeah.
49:53That one has to see very specifically what has gone on in the family, how it's affected the parents and
50:05the child.
50:06And I could give you one example of that, which also ties in with transference, counter-transference.
50:18I was seeing an Indian woman in New York, and she was actually having a lot of, she was a
50:31very bright woman who was accepted at Ivy League colleges, etc.
50:37And at one point she went on into psychiatry herself, and the program she was in had a psychoanalytic training
50:56program also attached to it.
50:59And one day she walked, meanwhile she'd been telling me that one of her problems is she never feels very
51:11comfortable with other Americans, only with Indian Americans, but not with those from a European background.
51:23And she assumed, well, you know, she came over to the United States when she was five.
51:31So, at the time, if she works, if she went into that psychoanalytic program, she could not continue an analysis
51:41with me.
51:43And I felt like I was being abandoned, etc.
51:50But, as I say, I've learned enough, not only not to take it personally, but to see how it ties
52:00in with her.
52:00And the way it tied in with her was in this joint family in which she was raised in a
52:11North Indian city, she was the first grandchild.
52:17She was adored by all the aunts, uncle, grandparents, whatever.
52:25In fact, she said they had 50 different terms of endearment for her.
52:32Somehow, something happened in the family, I'm not sure of the details, where her father decided to immigrate to the
52:44United States.
52:45He didn't have to economically. This was a well-off family. But he did.
52:53The mother, as was not uncommon in those days when there were fewer Indians in the United States, became rather
53:03depressed and had a difficult time because she felt very isolated.
53:08The father, less so at work. But the daughter lost the whole feelings of the closeness and endearment within the
53:20joint family.
53:21And actually, this was my feeling that I was having, that she was feeling of being cut off, potentially cut
53:33off and abandoned.
53:34And it was from there that we figured out that the unease with other Americans was actually related to her
53:47feeling cut off from the family, that she would never have them again.
53:53So, you certainly want to see, as much as one can, what the effects are within the whole family system
54:06and how this is affecting the patient.
54:09And I know it is much more complex here than it is within most Western countries.
54:31So, I would like to thank you all for being here and being such a good, you know, such a
54:37good contributing audience, in fact, to the kind of issues we have raised.
54:41I would like to really thank Dr. Roland for being here and we hope to see you again, you know,
54:50for maybe something for a two-day thing, a one-day thing at least.
54:55Yeah. And so, we'll stop here. Please do fill in the feedback forms. Also, mentioning, you know, if you want,
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